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. 2013 May;15(5):365-71.
doi: 10.1111/j.1477-2574.2012.00585.x. Epub 2012 Oct 11.

Recurrence after microwave ablation of liver malignancies: a single institution experience

Ryan T Groeschl  1 , Ray K Wong, Edward J Quebbeman, Susan Tsai, Kiran K Turaga, Sam G Pappas, Kathleen K Christians, Eric J Hohenwalter, Sean M Tutton, William S Rilling, T Clark Gamblin
Affiliations

Recurrence after microwave ablation of liver malignancies: a single institution experience

Ryan T Groeschl et al. HPB (Oxford). 2013 May.

Abstract

Background: Microwave ablation (MWA) is increasingly used to achieve local control for liver tumours. This study sought to examine a monocentric experience with MWA, with a primary hypothesis that primary tumour histology was a significant predictor of early recurrence.

Methods: Retrospective single-institution review identified consecutive patients with liver tumours treated by MWA. Cox proportional hazards models assessed significance of prognostic variables.

Results: Seventy-two patients (43 female, 60%) underwent 83 MWA procedures for 157 tumours. Tumour histologies included hepatocellular cancer (10 operations), colorectal metastases (39), metastatic carcinoid (20) and other (14). The median tumour size was 2.0 cm. A concomitant liver resection was performed in 50 cases (60%). Crude peri-operative morbidity and mortality rates were 16% and 1%, respectively. The median follow-up was 16 months. Ablations were complete for 149 out of 157 tumours (95%). The median overall and recurrence-free survivals were 36 and 18 months, respectively. There was no difference in time to recurrence between the primary tumour types. In multivariable models, recurrence-free survival was independently associated with the use of neoadjuvant [hazard ratio (HR): 2.90, 95% confidence interval (CI): 1.09-7.76, P = 0.034] and adjuvant chemotherapy (HR: 0.36, 95% CI: 0.15-0.82, P = 0.016).

Conclusions: MWA is a safe and feasible approach for local control of liver tumours. While chemotherapy administration was associated with time to recurrence after MWA, larger studies are needed to corroborate these findings.

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Figures

Figure 1
Figure 1
The number of tumours ablated by a liver segment during 83 microwave ablation procedures (n = 157). Published with permission from © brysonbiomed.com
Figure 2
Figure 2
Recurrence-free survival (a) and overall survival (b) curves, by primary malignancy. HCC, hepatocellular carcinoma; CLM, colorectal liver metastatses; MC, metastatic carcinoid
See this image and copyright information in PMC

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